The Development Psychology of Psychopathology, Sam Vaknin [e book reader TXT] 📗

big objects to small ones, black and white to colored (because of the sharper contrast), curved lines to straight ones (this is why babies prefer human faces to abstract paintings). They prefer their mother to strangers. It is not clear how they come to recognize the mother so quickly. To say that they collect mental images which they then arrange into a prototypical scheme is to say nothing (the question is not “what” they do but “how” they do it). This ability is a clue to the complexity of the internal mental world of the neonate, which far exceeds our learned assumptions and theories. It is inconceivable that a human is born with all this exquisite equipment while incapable of experiencing the birth trauma or the even the bigger trauma of his own inflation, mental and physical.

As early as the end of the third month of pregnancy, the fetus moves, his heart beats, his head is enormous relative to his size. His size, though, is less than 3 cm. Ensconced in the placenta, the fetus is fed by substances transmitted through the mother’s blood vessels (he has no contact with her blood, though). The waste that he produces is carried away in the same venue.

The composition of the mother’s food and drink, what she inhales and injects - all are communicated to the embryo. There is no clear relationship between sensory inputs during pregnancy and later life development. The levels of maternal hormones do effect the baby’s subsequent physical development but only to a negligible extent. Far more important is the general state of health of the mother, a trauma, or a disease of the fetus. It seems that the mother is less important to the baby than the romantics would have it - and cleverly so. A too strong attachment between mother and fetus would have adversely affected the baby’s chances of survival outside the uterus. Thus, contrary to popular opinion, there is no evidence whatsoever that the mother’s emotional, cognitive, or attitudinal state effects the fetus in any way. The baby is effected by viral infections, obstetric complications, by protein malnutrition and by the mother’s alcoholism. But these - at least in the West - are rare conditions.

In the first three months of the pregnancy, the central nervous system “explodes” both quantitatively and qualitatively. This process is called metaplasia. It is a delicate chain of events, greatly influenced by malnutrition and other kinds of abuse. But this vulnerability does not disappear until the age of 6 years out of the womb. There is a continuum between womb and world. The newborn is almost a very developed kernel of humanity. He is definitely capable of experiencing substantive dimensions of his own birth and subsequent metamorphoses. Neonates can immediately track colors - therefore, they must be immediately able to tell the striking differences between the dark, liquid placenta and the colorful maternity ward. They go after certain light shapes and ignore others.

Without accumulating any experience, these skills improve in the first few days of life, which proves that they are inherent and not contingent (learned). They seek patterns selectively because they remember which pattern was the cause of satisfaction in their very brief past. Their reactions to visual, auditory and tactile patterns are very predictable. Therefore, they must possess a MEMORY, however primitive.

But - even granted that babies can sense, remember and, perhaps emote - what is the effect of the multiple traumas they are exposed to in the first few months of their lives?

We mentioned the traumas of birth and of self-inflation (mental and physical). These are the first links in a chain of traumas, which continues throughout the first two years of the baby’s life. Perhaps the most threatening and destabilizing is the trauma of separation and individuation.

The baby’s mother (or caregiver - rarely the father, sometimes another woman) is his auxiliary ego. She is also the world; a guarantor of livable (as opposed to unbearable) life, a (physiological or gestation) rhythm (=predictability), a physical presence and a social stimulus (an other).

To start with, the delivery disrupts continuous physiological processes not only quantitatively but also qualitatively. The neonate has to breathe, to feed, to eliminate waste, to regulate his body temperature - new functions, which were previously performed by the mother. This physiological catastrophe, this schism increases the baby’s dependence on the mother.

It is through this bonding that he learns to interact socially and to trust others. The baby’s lack of ability to tell the inside world from the outside only makes matters worse. He “feels” that the upheaval is contained in himself, that the tumult is threatening to tear him apart, he experiences implosion rather than explosion. True, in the absence of evaluative processes, the quality of the baby’s experience will be different to ours. But this does not disqualify it as a PSYCHOLOGICAL process and does not extinguish the subjective dimension of the experience. If a psychological process lacks the evaluative or analytic elements, this lack does not question its existence or its nature. Birth and the subsequent few days must be a truly terrifying experience.

Another argument raised against the trauma thesis is that there is no proof that cruelty, neglect, abuse, torture, or discomfort retard, in any way, the development of the child. A child - it is claimed - takes everything in stride and reacts “naturally” to his environment, however depraved and deprived.

This may be true - but it is irrelevant. It is not the child’s development that we are dealing with here. It is its reactions to a series of existential traumas. That a process or an event has no influence later - does not mean that it has no effect at the moment of occurrence. That it has no influence at the moment of occurrence - does not prove that it has not been fully and accurately registered. That it has not been interpreted at all or that it has been interpreted in a way different from ours - does not imply that it had no effect. In short: there is no connection between experience, interpretation and effect. There can exist an interpreted experience that has no effect. An interpretation can result in an effect without any experience involved.

And an experience can effect the subject without any (conscious) interpretation. This means that the baby can experience traumas, cruelty, neglect, abuse and even interpret them as such (i.e., as bad things) and still not be effected by them. Otherwise, how can we explain that a baby cries when confronted by a sudden noise, a sudden light, wet diapers, or hunger? Isn’t this proof that he reacts properly to “bad” things and that there is such a class of things (“bad things”) in his mind?

Moreover, we must attach some epigenetic importance to some of the stimuli. If we do, in effect we recognize the effect of early stimuli upon later life development.

At their beginning, neonates are only vaguely aware, in a binary sort of way.

l.“Comfortable/uncomfortable”, “cold/warm”, “wet/dry”, “color/absence of color”, “light/dark”, “face/no face” and so on. There are grounds to believe that the distinction between the outer world and the inner one is vague at best. Natal fixed action patterns (rooting, sucking, postural adjustment, looking, listening, grasping, and crying) invariably provoke the caregiver to respond. The newborn, as we said earlier, is able to relate to physical patterns but his ability seems to extend to the mental as well. He sees a pattern: fixed action followed by the appearance of the caregiver followed by a satisfying action on the part of the caregiver. This seems to him to be an inviolable causal chain (though precious few babies would put it in these words). Because he is unable to distinguish his inside from the outside - the newborn “believes” that his action evoked the caregiver from the inside (in which the caregiver is contained). This is the kernel of both magical thinking and Narcissism.

The baby attributes to himself magical powers of omnipotence and of omnipresence (action-appearance). It also loves itself very much because it is able to thus satisfy himself and his needs. He loves himself because he has the means to make himself happy. The tension-relieving and pleasurable world comes to life through the baby and then he swallows it back through his mouth. This incorporation of the world through the sensory modalities is the basis for the “oral stage” in the psychodynamic theories.

This self-containment and self-sufficiency, this lack of recognition of the environment are why children until their third year of life are such a homogeneous group (allowing for some variance). Infants show a characteristic style of behaviour (one is almost tempted to say, a universal character) in as early as the first few weeks of their lives. The first two years of life witness the crystallization of consistent behavioral patterns, common to all children. It is true that even newborns have an innate temperament but not until an interaction with the outside environment is established - do the traits of individual diversity appear.

At birth, the newborn shows no attachment but simple dependence. It is easy to prove: the child indiscriminately reacts to human signals, scans for patterns and motions, enjoys soft, high pitched voices and cooing, soothing sounds. Attachment starts physiologically in the fourth week. The child turns clearly towards his mother’s voice, ignoring others. He begins to develop a social smile, which is easily distinguishable from his usual grimace. A virtuous circle is set in motion by the child’s smiles, gurgles and coos. These powerful signals release social behaviour, elicit attention, loving responses.

This, in turn, drives the child to increase the dose of his signaling activity. These signals are, of course, reflexes (fixed action responses, exactly like the palmar grasp). Actually, until the 18th week of his life, the child continues to react to strangers favorably. Only then does the child begin to develop a budding social-behavioral system based on the high correlation between the presence of his caregiver and gratifying experiences. By the third month there is a clear preference of the mother and by the sixth month, the child wants to venture into the world. At first, the child grasps things (as long as he can see his hand). Then he sits up and watches things in motion (if not too fast or noisy). Then the child clings to the mother, climbs all over her and explores her body. There is still no object permanence and the child gets perplexed and loses interest if a toy disappears under a blanket, for instance. The child still associates objects with satisfaction/non-satisfaction. His world is still very much binary.

As the child grows, his attention narrows and is dedicated first to the mother and to a few other human figures and, by the age of 9 months, only to the mother. The tendency to seek others virtually disappears (which is reminiscent of imprinting in animals). The infant tends to equate his movements and gestures with their results - that is, he is still in the phase of magical thinking.

The separation from the mother, the formation of an individual, the separation from the world (the “spewing out” of the outside world) - are all tremendously traumatic.

The infant is afraid to lose his mother physically (no “mother permanence”) as well as emotionally (will she be angry at this new found autonomy?). He goes away a step or two and runs back to receive the mother’s reassurance that she still loves him and that she is still there. The tearing up of one’s self into my SELF and the OUTSIDE WORLD is an unimaginable feat. It is equivalent to discovering irrefutable proof that the universe is an illusion created by the brain or that our brain belongs to a universal pool and not to us, or that we are God (the child discovers that he is not God, it is a discovery of the